VICTIG Healthcare Sanction Checks
The well-being of a healthcare facility hinges upon the quality of its employees. When hiring people to handle matters of life and death, organizations within the healthcare industry must be especially selective — and medical sanctions searches are some of the most important checks to remember to ensure regulatory compliance and high-caliber staff members. This article will discuss what healthcare sanctions searches are, why they’re important, and how you can maintain compliance within your healthcare clinic.
What Is a Health Care Sanctions Search?
A sanction is a type of penalty for noncompliance with government programs. If a medical worker has ever committed fraud or abuse in the healthcare industry, they are added to a health care sanctions list — the Office of the Inspector General (OIG) List of Excluded Individuals/Entities (LEIE) kept by the US Department of Health and Human Services. This list bars offenders from receiving payment from federal health care programs for items or services they have rendered, and even prevents them from working for Medicare- or Medicaid-providing health care institutions.
If a healthcare organization offering care under federal programs like Medicare or Medicaid hires an individual who is listed on the LEIE, they could incur hefty monetary penalties or jail sentences. Thus, sanction checking is a crucial part of the background screening process. It checks for a candidate’s name on over a thousand government employment-ban lists for any suspensions or other disciplinary actions, including the LEIE and many more. This step mitigates the risk of hiring workers who may jeopardize your organization.
By conducting the search, you can find out who took the disciplinary action against the health care worker, how long the employment ban will remain in effect, and sometimes, why the person was added to the list in the first place.
How Long Does the OIG Employment Ban Remain in Effect?
People don’t usually stay on the medical sanctions list forever; the amount of time an individual’s name remains on the list depends on the severity of the offense. For example, some criminal convictions are tied to 10-year durations while others may be much shorter. In other cases, exclusions may be imposed indefinitely, such as those from licensing boards. The OIG is required by law to impose a minimum of a five-year exclusion for patient abuse, fraud, illegal prescription of controlled substances, and other program-related crimes.
If a person’s medical license has been revoked and subsequently restored, they can request that their name be removed from the list upon the reinstatement of their license. This does not happen automatically, however; the individual must formally request it.
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Why Is It Important to Conduct Healthcare Sanction Screening?
1. To protect patients, staff members, and your organizational health as a whole
Health care centers rely on word-of-mouth referrals and positive public perception to survive. Fraud and abuse are serious offenses that have the potential to ruin the reputation of a healthcare organization. A person may be added to the LEIE for the following types of convictions and felony crimes:
- Patient neglect, abuse, or medical misconduct
- Financial mismanagement
- Theft of medical equipment or medicine
- Medicare/Medicaid or other health care-related fraud
- Illegal prescription or distribution of controlled substances
2. To avoid OIG-imposed fines for inadvertently hiring sanctioned persons
Failing to conduct a thorough health care sanction check can lead to a mishire. When you do business with a sanctioned person, the OIG has the power to subject your institution to a $10,000 fine for each occurrence.
3. To ensure future eligibility for federal benefits and programs
Federal programs like Medicare and Medicaid ensure that hospitals still get paid for caring for patients who have no private insurance coverage. Without these programs, hospital staff goes uncompensated for care rendered to people who cannot pay. If you want to ensure your eligibility for government-sponsored insurance, you must be diligent in your hiring process. Otherwise, you could hire an excluded individual and disqualify yourself from these federal programs.
How to Remain Compliant With Health Care Regulations
Federal regulations seem to change constantly, which makes it difficult to stay in compliance with health care industry requirements.
Below are some simple ways you can protect yourself from costly liabilities:
- Check the LEIE on at least a weekly basis for candidate and current employee names to ensure consistent compliance and safety for patients and staff.
- Make health care sanctions checks a routine part of your background checks.
- Hire only those who are currently qualified for the work they will be doing.
- Use updated monitoring technology to automate the tedious and mundane aspects of sanction checks and expand your checks across departments and facilities.
- Partner with a third-party background screening service for the most up-to-date screening capabilities and eliminate the hassle.
Why Choose VICTIG for Health Sanction Checks?
While the federal government offers some assistance in achieving compliance with health care regulations, the use of government tools can be complex and overwhelming. What’s more, if you are too thorough with health care exclusion checks, you might come across multiple matches for the same name on an exclusion list and end up refusing employment to the wrong person — which could be interpreted as employment discrimination.
There are so many things that could go wrong in a health care sanctions background check, but you’re not alone in it. VICTIG is an experienced background screening service that offers extensive search capabilities within the healthcare industry. We pride ourselves on taking the burden off your shoulders as a healthcare administrator while providing the most accurate search reports you could ask for. When you partner with our expert team, you eliminate the risk from your hiring process and can feel confident in hiring high-quality candidates who will help you grow your health clinic.
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